Lamellar keratoplasty (Deep anterior lamellar keratoplasty, Descemet stripping endothelial keratoplasty, Descemet membrane endothelial keratoplasty) is a procedure that only replaces abnormal layers in the recipient cornea, which is a transplantation method that increases the success rate of transplantation and lowers post-transplant complications compared to the conventional penetrating keratoplasty method of transplanting the whole cornea. Due to its superiority over the penetrating keratoplasty, lamellar keratoplasty is already commonly practiced in the US and Europe, and its frequency of practice is higher than that of penetrating keratoplasty.
However, lamellar keratoplasty requires a process of reshaping the corneas of both the graft recipient and the donor, and it is now performed manually depending on the operator's senses. Hence, there is a problem that the accuracy and reproducibility of the corneal dissection vary widely depending on the operator's experience and dexterity.
Optical coherence tomography (OCT), which uses a light interference technique to acquire a tomographic image, can be used to acquire a corneal tomographic image before surgery and identify the interfaces between corneal layers in advance. Such OCT technology is similarly disclosed in Korean Patent Laid-Open Publication No. 10-2014-0104584.
However, even if there is a tomographic image available through OCT, the operation of manual dissection of the cornea may still depend on the operator's dexterity, and the depth of the injection needle depends on the operator's experience. There still is a problem that the accuracy and reproducibility of the corneal reshaping vary widely.
Therefore, in order to increase the success rate of the lamellar keratoplasty and to effectively use a limited number of donor corneas, there is a high need for a technique capable of accurately reshaping the cornea with less variation in reproducibility.